Similar Drugs

Nexium is the brand name for esomeprazole, a drug used to treat certain
stomach and esophagus problems.

Nexium belongs to a class of drugs called proton pump inhibitors, which
help block the production of acid in the stomach. Nexium relieves
heartburn,
difficulty swallowing, and persistent cough caused by acid reflux. It
also helps heal acid damage to the stomach and esophagus, prevents
ulcers, and may
help prevent cancer in the esophagus.

The Food and Drug Administration (FDA) approved esomeprazole in 2001.
Pfizer bought the rights to the over-the-counter (OTC) version of
Nexium from
AstraZeneca in 2012.

In 2014, the patent expired, and a new OTC Nexium was introduced.
AstraZeneca reportedly slashed thousands of jobs in the face of
diminished revenues due
to the expiration of the Nexium patent.

Nexium is approved for the treatment of gastro reflux disease, and in
combination with antibiotics, for the treatment of patients with H.
pylori
infection. It is also used to reduce the risk of gastric ulcers and in
the treatment of Zollinger-Ellison syndrome.

Nexium (Esomeprazole) Warnings

People with a history of liver disease or of Asian descent should
inform their physician, because side effects may be potentially worse
in these people.

You should also tell your doctor if you have any of the following:

Trouble swallowing

Bloody stools or vomit

Heartburn lasting more than three months

Chest pain

Unexplained weight loss

Studies show an increased risk of fracture associated with high doses
and long-term use associated with Nexium.

A study published in the December 27, 2006 Journal of the American
Medical Association shows that long-term use of Nexium and other proton
pump inhibitors
increases the risk of hip fractures in people over 50.

A 2010 study published in the Archives of Internal Medicine found a 25
percent higher chance of a spine or wrist fracture in postmenopausal
women who took
Nexium.

Nexium (Esomeprazole) Interactions

Tell your doctor about any allergies you have, and about all the
medications you take, whether prescription or over-the-counter,
vitamins, illegal or
recreational drugs, and dietary or herbal supplements, as they can
affect how Nexium works, and vice-versa.

Nexium can increase the concentration of diazepam (Valium) in the
blood, and the two should not be mixed. Because Nexium reduces stomach
acid, it may
decrease the absorption of antifungals such as ketoconazole (Nizoral),
and increase the absorption of digoxin (Lanoxicaps, Lanoxin) causing
possible
toxicity.

Also, Nexium may increase blood levels of saquinavir (Fortovase,
Invirase) and reduce levels of nelfinavir (Viracept) and atazanavir
(Reyataz), so using
these medications together should be avoided.

Nexium (Esomeprazole) Dosage

The over-the-counter (OTC) version of Nexium is available in
20-milligram (mg) capsules. Patients should not use this medication
more than 14 days in a
row, unless directed by their doctor.

Nexium purple capsules with thin yellow stripes should be taken one
hour before meals, swallowed whole, and not chewed or crushed. Those
patients with
difficulty swallowing can open capsule and mix with applesauce.

Average prescription strength dosing is as follows, although your
doctor may prescribe different doses for you:

For adults: 20 to 40 mg, once daily for four to eight weeks

For children (ages 1 to 11): 10 to 20 mg daily

For treatment of H. pylori: 40 mg,
once daily along with amoxicillin (Amoxicot, Amoxil, Biomox) and
clarithromycin (Biaxin), for 10 days.

Zollinger-Ellison syndrome: 40 mg, twice daily

Nexium (Esomeprazole) Overdose

If you take too much medication, contact poison control at
1-800-222-1222 or call 911 for immediate attention.

Typical signs of an overdose include:

Blurred vision

Fast heartbeat

Excessive drowsiness

Sweating

Dry mouth

Nausea

Confusion

Convulsions

Missed Dose of Nexium (Esomeprazole)

If you miss a dose, take it as soon as possible, but do not â€œdouble upâ€
to make up for a missed dose.

Nexium Pictures

Nexium 20 mg, purple, capsule,

Nexium 40 mg, purple, capsule,

Nexium FAQ

Q: I have stomach problems and have taken Nexium for years; the doctors never changed it. But i saw it says take for six to eight weeks. How often should I get it checked? It's a maintenance medicine for me. I also have GERD.

A: Nexium has a notation in its literature that it is to be used for six to eight weeks; however, this medication is being used on a long-term basis under your health-care provider's supervision. You may want to ask if there is a different medication that could help with your stomach problem. Prevacid is a product that has just gone OTC and you may ask about trying this. Zergerid is another product on the market that contain omeprazole and sodium bicarbonate. For more information on GERD, you can go to http://www.everydayhealth.com/gerd/understanding.aspx.

Q: I take the following medications. Nexium, Toporol, Diovan HCT, and Metformin. Do any of these cause weight gain?

A: Weight gain is a rare side effect of Nexium, occurring in less than 1 percent of patients who take it. The other medications you listed do not appear to cause weight gain, according to their prescribing information. If you are noticing a sudden weight change, it is best to consult your physician.

Q: Does Nexium cause weight gain?

A: According to the package insert for Nexium, weight gain and weight loss are both listed as a possible or probable side effect occurring in less than 1 percent of patients. There may be many factors that can contribute to weight gain, it is important to consult with your physician or health care provider about any specific questions regarding your medical conditions or medications; particularly before taking any action. To learn about GERD or digestive health on Everyday Health's Web site, follow these links: http://www.everydayhealth.com/gerd/understanding.aspxhttp://www.everydayhealth.com/digestive-health/index.aspx

Q: Does Nexium make it harder to lose weight?

A: According to the package insert for Nexium, weight gain and weight loss are both listed as a possible or probable side effect occurring in less than 1 percent of patients. There can be many factors that can contribute to weight gain or weight loss, it's important to consult with your physician or health care provider about any specific questions regarding your medical conditions or medications; particularly before taking any action. Learn more about GERD or digestive health at Everyday Health here: http://www.everydayhealth.com/gerd/understanding.aspxhttp://www.everydayhealth.com/digestive-health/index.aspx

Q: Is there a generic version of Nexium?

A: While every medication on the market has an active ingredient name, as in this case, esomeprazole, it is usually only available as the brand until the patent rights have expired. In this case, Nexium is not available as a generic yet. There are other, less expensive medications on the market, such as Prilosec, Prevacid, and Protonix, as an alternative.

Q: My insurance will not cover Nexium. What is the best replacement?

A: Unfortunately, this question does not have a simple answer. The appropriate answer to your question involves many things. Firstly, you may want to contact your insurance company, prior to speaking with your doctor, and request a formulary. A formulary is a list of the medications they prefer and the different levels of coverage specific to your plan. Then it is important to contact your healthcare provider and based on your individual needs and the formulary list of covered medications, the best treatment option can be determined.

Q: I've been considering getting my prescription for Nexium from a Canadian pharmacy instead of the provider that my insurance requires me to. The difference in cost is about $100 per month and I am tired of over paying. Are there reputable pharmacies that can be trusted in Canada or is this a risky situation that I should stay away from? I would appreciate your input. My wife and I are on an HSA type of plan and we pay over $400 every three months for my 40mg Nexium.

A: The U.S. Food and Drug Administration (FDA) states the following about buying medications outside the United States. Medicine purchased over the Internet from foreign sources, from storefront businesses that offer to buy foreign medicine, or during trips outside the United States, may not be safe or effective. These medicines may present health risks and the FDA cannot ensure the safety of medicine from these sources. The FDA cannot help if problems arise with medicine that is obtained from outside U.S. regulation and oversight. The FDA states that if people purchase drugs outside of the U.S., they are taking a risk. The following problems could be associated with medications purchased outside the U.S.: The medication may not have been made under quality assurance procedures designed to produce a safe and effective product, the medication could be a counterfeit which is unsafe or even completely ineffective, the medication could have untested substances and be dangerous, the medicine's label, including instructions for use and possible side effects, may be in a language you do not understand and may make medical claims or suggest specific uses that have not been adequately evaluated for safety and effectiveness, the medicine may lack information that would permit you to be promptly and correctly treated for a dangerous side effect caused by the medicine. It is important to consult your physician or healthcare provider about any specific questions regarding your medical conditions or medications; particularly before taking any action.
Derek Dore, PharmD

Q: Will Nexium make you gain weight?

A: Weight gain is not a common side effect of Nexium (esomeprazole). According to the prescribing information for Nexium, weight gain was reported by less than 1% of patients in clinical trials. Consult your healthcare provider for any changes in your medical condition, including unusual weight gain. Do not stop or change the amount of medication you take without talking to your healthcare provider first. See also http://www.everydayhealth.com/drugs/nexium and http://www.everydayhealth.com/weight/calories.aspx
Sarah Lewis, PharmD

Q: Do I need a prescription to buy Nexium, or can I get it over the counter? if it's only by prescription, is there something similar to Nexium I can get over the counter?

A: Nexium is still only available by prescription. Nexium is part of a class of drugs called proton pump inhibitors (PPIs). Several types of proton pump inhibitors are available by prescription only but there are a few that are available over the counter. Prilosec is now available and would be the closest thing to Nexium that you can get over the counter. Be sure to check with your physician before taking Prilosec because it can interact with some medications like Plavix.
Lori Poulin, PharmD

Q: I am currently taking Nexium and am concerned about gaining weight. Does it cause weight gain?

A: Weight gain is not a common side effect of Nexium (esomeprazole). According to the prescribing information for Nexium, weight gain was reported by less than 1 percent of patients in clinical trials. Consult your healthcare provider for any changes in your medical condition, including unusual weight gain. Do not stop or change the amount of medication you take without talking to your healthcare provider first. You may also find helpful information at http://www.everydayhealth.com/drugs/nexium and http://www.everydayhealth.com/weight/calories.aspx. Sarah McKenney Lewis, PharmD

Q: I'm interested in taking Nexium. Is it available over the counter? If not, is there something similar available?

A: I believe your question is if you can get Nexium over the counter. The answer is not yet. This medication is still only available by prescription. Nexium is part of a class of drugs called proton pump inhibitors (PPIs). Several types of proton pump inhibitors are available by prescription only but there are a few that are available over the counter. Prilosec is now OTC and would be the closest thing to Nexium that you can get over the counter. Be sure to check with your physician before taking prilosec because it can interact with some medications, like Plavix, and can cause more harm than good. Lori, PharmD

Q: I have been experiencing throat pain and my primary physician prescribed Nexium to determine if this is due to acid reflux. I'm unsure if I'm to take this prior to dinner or prior to every meal.

A: Nexium (Esomeprazole) http://www.everydayhealth.com/drugs/nexium is a proton pump inhibitor. Basically, the inhibition of proton pump will block secretion of stomach acid. In the presence of food, proton pumps are activated. Nexium should be taken at about 1 hour before meal. This will allow time for Nexium to absorb into the blood stream. In the presence of food, proton pumps are activated to produce acid and Nexium is readily available to block this process. Nexium has a half-life of 1-2 hours; meaning 50% of it is eliminated out of the blood after this time. This is why it may not be as effective when taken at other time. It should not be taken as needed because not all proton pumps are inactivated with the first dose. It may take up to 4 days of continuous use to get the full effect. For more information, please visit http://www.everydayhealth.com/gerd/understanding.aspx Lori Mendoza, PharmD

Q: I have been taking Nexium for 2 years, and I just recently had my annual exam and blood tests. Everything was perfect except my last liver enzymes. Could this be a problem? I have been off the Nexium for a week.

A: According to the package insert for Nexium, elevated liver enzymes can occur in less than 1 percent of people who take it. Fortunately, the liver is one of the fastest healing organs in our body. This is not a common side effect and does not normally show up on patient information sheets since it is so uncommon. It is good that your doctor is monitoring your liver function and it would be good to have them continue to monitor your AST and ALT levels. Megan Uehara, PharmD

Q: I have acid reflux and hiatus hernia. Should I be taking Nexium, even though I am not bothered with problems?

A: The decision on whether or not you need to be on a medication should be made by your health care provider. There are many variables in this decision. If you are currently taking Nexium (esomeprazole) (http://www.everydayhealth.com/drugs/nexium) you may not be having symptoms because the medication is working for you. As always, talk with your health care provider regarding questions you have about your medication. The following link will take you to information provided by Everyday Health regarding acid reflux or GERD: http://www.everydayhealth.com/gerd/understanding.aspx. Jen Marsico, RPh

Q: I have been taking Nexium for about three years. As long as I take it, I have no problems but if I forget to take it as soon as I get up, within an hour I have pain in my chest and unbearable heartburn. I recently heard that Nexium could cause you to have fractures of the bones. Should I be concerned? I also take Coumadin and lovastatin.

A: I have reviewed your question regarding Nexium (esomeprazole), Coumadin (warfarin), and Mevacor (lovastatin). I found one drug-drug interaction: warfarin sodium (in Coumadin tablets) may interact with lovastatin (in Mevacor tablets). Lovastatin may block the breakdown of warfarin by the liver and its clearance from the body. If this happens, blood levels of warfarin could be increased and this could increase its anticoagulant effect. Warfarin is generally used to prevent your blood from "coagulating" or forming blood clots. When lovastatin and warfarin are used at the same time, your blood may be much less likely to clot and this may increase the risk of excessive bleeding. If these drugs are taken together, your doctor may want to monitor you closely when therapy with lovastatin is either started or stopped. Blood tests can be used to make sure that you are getting the right amount of warfarin. If you are experiencing problems, it may be necessary to adjust the dose of warfarin. Discuss this potential interaction with your health care provider at your next appointment, or sooner if you think you are having problems. This interaction is well-documented and is considered moderate in severity. Nexium (esomeprazole) is in a class of drug called a proton pump inhibitor. Proton pump inhibitors may be associated with a greater risk of hip fractures. I would discuss this with your physician or health care provider. Please review the information on GERD at Everyday Health http://www.everydayhealth.com/gerd/understanding.aspx For immediate questions or concerns, please contact your physician or health care provider. Joseph Hall, RPh.

Q: Does Nexium cause breakouts?

A: Nexium (esomeprazole) is a proton pump inhibitor used for gastroesophageal reflux disease and ulcers. According to Lexi-Comp side effects of Nexium during clinical trials included skin rash and itching. Discuss any side effects you may be having with your health care provider. Please see the following Everyday Health link for more information on Nexium (esomeprazole). http://www.everydayhealth.com/drugs/nexium Laura Cable, PharmD

Q: I have been on Nexium for four years but find the cost is more than I can afford. Is the drug Kapidex any less expensive?

A: The price of Nexium or Kapidex (which is now called Dexilant) can vary depending on the wholesaler and pharmacy from which the medication is acquired. Pharmacies sell medication to consumers at a price that includes the cost for acquiring the drug from the wholesaler, plus a retail markup. If a third-party payer (for example, a health insurance company or Medicare) is providing coverage for Nexium or Dexilant, they determine the final cost of the product. Costs will vary from one plan to another, and the payer may cover or reimburse part or all of the cost. It would be best to call your insurance provider and ask where these medications fall into your particular formulary (list of medications that your plan covers) and see which might be preferred and they can give you the copay information for each medication. Another option would be to go to the manufacturer websites to see if they offer any prescription assistance in the form of a coupon or voucher than can be used to offset your copay expense. Here are the links to the manufacturer website for information on patient assistance programs: http://www.dexilant.com/DEXILANTAdvantage.aspxhttp://www.purplepill.com/about-nexium/cost.aspx. For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. Lori Mendoza, PharmD Poulin, PharmD

Q: I take Nexium, and become nauseated soon after even with liquids and/or food. Why does this occur?

A: Nausea is one of the more common side effects of Nexium. Many people do experience this and some claim that the nausea goes away after they have been on the Nexium for a few weeks. It is not really known why this side effect occurs. If the nausea is too bothersome for you, it would be best to speak with your doctor to see if you should lower your dose or change your medication. Megan Uehara, PharmD

Q: What are the interactions, if any, between Plavix and Nexium? I had to switch from Protonix to Nexium for insurance reasons.

A: Since you are on Plavix (clopidogrel), you should not be taking Nexium (esomeprazole). New studies state that these products should not be taken together and that patients should use Zantac (ranitidine) or Pepcid (famotidine) instead. Contact your health care provider and let him or her know about the medication your insurance company put you on. Gerald S. Levy, RPh

Q: I read that Nexium is given for short-term use, but I have been taking Nexium daily for many years. What are the side effects when taken long-term?

A: Nexium (esomeprazole) is indicated for the treatment of GERD or gastroesophageal reflux disease. Nexium relieves heartburn that is caused by the backflow of stomach acid from the stomach to the esophagus. (http://www.everydayhealth.com/drugs/nexium). Common side effects associated with Nexium include dizziness, headache, diarrhea, constipation and dry mouth. Other less common side effects associated with Nexium include muscle pain, rash, back pain and chest pain. (http://www.everydayhealth.com/gerd/understanding.aspx). Depending on the diagnosis, Nexium can be prescribed as a short term therapy or daily as a maintenance dose. Consult with the doctor about any side effects you may be experiencing from the Nexium. Also it is important when your doctor prescribes a new medication, be sure to discuss all your medications and over-the-counter drugs, including dietary supplements, vitamins, botanicals, minerals and herbals, as well as the foods you eat. Also keep a current list of the drugs and supplements you take and review it with your healthcare provider and your pharmacist. If possible, use one pharmacy for all your prescription medications and over-the-counter products. This allows your pharmacist to keep a complete record of all your prescription drugs and to advise you about drug interactions and side effects. For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. Kimberly Hotz, PharmD

Q: Does Nexium make me gain weight?

A: Drugs can cause weight gain in several different ways. Some can increase appetite or make you crave certain types of foods like those high in carbohydrates or fat. Other medications may slow down metabolism or cause fluid retention. However, the effect of prescription drugs on body weight is complex. Some drugs have no effect on weight, while others cause weight gain or weight loss. Also, the same medications can cause weight gain in certain individuals and weight loss in others. There are also drugs that initially cause weight loss and then lead to weight gain with long-term use. Most prescription medications associated with changes in body weight affect the central nervous system. These include antidepressants like monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants, and selective serotonin reuptake inhibitors (SSRIs). Mood stabilizers (lithium, valproic acid), antipsychotics, and anticonvulsants have also been linked with weight gain. Other drugs that have been reported to cause weight gain include diabetes medications (insulin, sulfonylureas, and thiazolidinediones), antihypertensive drugs, certain hormonal contraceptives, corticosteroids, antihistamines, some chemotherapy regimens, and antiretroviral protease inhibitors. Nexium (esomeprazole) has been reported to cause weight change, which could be a gain or loss. If you think a drug you are taking is causing weight gain, tell your health care provider. Do not stop any medication or change the dose without first talking to your provider. For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. Laura Cable, PharmD

Q: Can nexium cause weight gain? I take 40 mg.

A: Nexium (esomeprazole) is a medication used to treat conditions of the esophagus and stomach. It is in the family of medications called proton pump inhibitors and works by disabling the acid producing pumps in the stomach to decrease acid reflux. The prescribing information on Nexium does list weight gain as a rare side effect of the medication, occurring in less than 1 percent of patients taking Nexium during clinical trials of the medication. Since this percentage is so small, it is difficult to say whether Nexium was the cause of the weight gain. For more information on Nexium, click on this link: http://www.everydayhealth.com/drugs/nexium For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. Lori Poulin, PharmD

Q: I have been on Nexium 40 mg for five months and have noticed an increase in heart palpitations. Can this be connected?

A: Nexium (esomeprazole) is used to treat GERD (gastroesophageal reflux disease) and other conditions where stomach acid is too high. Heart palpitations are not listed as a side effect. However, a fast heartbeat may occur if a person overdoses. Other possible common side effects include headache, diarrhea, nausea, gas, stomach pain, constipation, and dry mouth. This is not a complete list of the side effects associated with Nexium. For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. When your doctor prescribes a new medication, be sure to discuss all your prescription and over-the-counter drugs, including dietary supplements, vitamins, botanicals, minerals, and herbals, as well as the foods you eat. Always keep a current list of the drugs and supplements you take and review it with your health care providers and your pharmacist. If possible, use one pharmacy for all your prescription medications and over-the-counter products. This allows your pharmacist to keep a complete record of all your prescription drugs and to advise you about drug interactions and side effects. Tell your health care provider about any negative side effects from prescription drugs. You can also report them to the U.S. Food and Drug Administration by visiting http://www.fda.gov/medwatch or by calling 1-800-FDA-1088. For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action.
Patti Brown, PharmD

Q: I am 23 years old. I was diagnosed with esophagitis and my doctor ask me to take Nexium 40 mg for all my life. I am worried that Nexium will cause osteoporosis, because I was had a hip fracture three years ago. So can Nexium cause osteoporosis, and how can I prevent that from happening?

A: Nexium (esomeprazole) (http://www.everydayhealth.com/drugs/nexium) is indicated for the treatment of GERD or gastroesophageal reflux disease. Nexium relieves heartburn that is caused by the backflow of stomach acid from the stomach to the esophagus. (http://www.everydayhealth.com/gerd/understanding.aspx). Common side effects associated with Nexium include dizziness, headache, diarrhea, constipation and dry mouth. Other less common side effects associated with Nexium include muscle pain, rash, back pain and chest pain. A search of prescribing information did not specifically list osteoporosis as an adverse event of Nexium. This is not a complete list of the side effects associated with Nexium. Kimberly Hotz, PharmD

Q: Can Nexium prevent the absorption of vitamin B? Should this medication be taken indefinitely?

A: Nexium (esomeprazole) belongs to a class of drugs called proton pump inhibitors (PPIs). PPIs decrease the amount of acid produced in the stomach. Nexium is used to treat symptoms of gastroesophageal reflux disease (GERD) and other conditions involving excessive stomach acid. It is also used to promote healing of erosive esophagitis (damage to your esophagus caused by stomach acid) and to prevent gastric ulcers. The PPIs have been on the market for over 20 years and have a very good safety record. However, there are some issues to consider with long-term use. In addition to producing acid, stomach cells also release a protein called intrinsic factor. Intrinsic factor is necessary for the proper absorption of vitamin B12 (cyanocobalamin). PPIs block the release of intrinsic factor along with stomach acid. So, with long-term use of PPIs over many years, it is possible to develop a vitamin B12 deficiency. Consult your doctor to see if cyanocobalamin supplementation is necessary based on your specific circumstances. Your doctor or health care provider is best able to guide your treatment decisions. Sarah Lewis, PharmD

Q: Sometimes after I eat I feel that I have an irregular heartbeat or feel bloated. I was put on Nexium which doesn't seem to help. Is this the right medication?

A: Your health care provider is best able to guide your treatment decisions based on your specific circumstances. Consult your health care provider for proper evaluation and diagnosis of your symptoms and for concerns about the effectiveness of Nexium for your condition. Nexium (esomeprazole) decreases the amount of acid produced in the stomach. It is used to treat symptoms of gastroesophageal reflux disease (GERD) and other conditions involving excessive stomach acid such as Zollinger-Ellison syndrome. Nexium is also used to promote healing of erosive esophagitis (damage to your esophagus caused by stomach acid). And it may also be given to prevent gastric ulcers caused by infection with helicobacter pylori (H. pylori), or by the use of nonsteroidal anti-inflammatory drugs (NSAIDs). You may also find helpful information at: http://www.everydayhealth.com/drugs/nexium Sarah Lewis, PharmD

Q: If you are taking Nexium, can you stop at any time?

A: Your question regards if you can stop taking Nexium (esomeprazole) http://www.everydayhealth.com/drugs/esomeprazole at any time. It is recommended to talk to your health care provider before stopping any prescription medication. If you do stop taking your medication, you may start to see symptoms returning of the condition that you initially were using it to treat (i.e. GERD). As always, talk with your health care provider regarding questions about your medications. Jen Marsico, RPh

Q: Are there any adverse effects from taking Nexium long-term?

A: Nexium (esomeprazole) is classified as a proton pump inhibitor and a substituted benzimidazole medication. Nexium works in the body to decrease the amount of acid produced by the stomach. Nexium is approved for the treatment of erosive esophagitis, GERD (gastroesophageal reflux disease), Helicobacter pylori (along with other medications), and in hypersecretory conditions including Zollinger-Ellison syndrome. Nexium, like any other medication, has possible side effects, risks, and warnings associated with its use. An alert was announced in in May 2010 about a possible increased risk of fractures of the hip, wrist, and spine associated with the proton pump inhibitor class of medications. The U.S. Food and Drug Administration (FDA) is in the process of revising the labeling for this class of medications and the risk of fractures. The greatest risk to patients were for those using the medication in high doses or taking the medication for longer than a year. According to medical references, the most common side effect of Nexium (occurring in greater than 10 percent of studied patients) is headache. Other common side effects include diarrhea, abdominal pain, and nausea. This is not a complete listing of all the associated side effects, risks, or warnings associated with the use of Nexium. According to the prescribing information, Nexium has been studied in both short-term and long-term studies. Long-term studies examined patients taking the medication for 6 to 12 months. In general, Nexium was said to be well tolerated in both the short-term and long-term clinical trials. For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. Jen Marsico, RPh

Q: How important is it to wait 60 minutes after eating before taking Nexium?

A: The manufacturer of Nexium recommends waiting one hour before eating after taking the medication. The reason is that when Nexium is taken with food, it is less available to the body. So yes, it is important to take the medication as recommended. For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. Jen Marsico, RPh

Q: I'm taking Nexium 40 mg once daily. Could this cause me to gain wieght? I also feel tired since I have been on this medication. Is it causing the fatigue?

A: Nexium (esomeprazole) is a proton pump inhibitor (PPI) used for the treatment of esophageal reflux disease (GERD), gastric ulcers and other conditions. According to Lexi-Comp, insomnia was reported in 2% of patients during clinical trials. Less than 1% of patients reported somnolence (drowsiness) or weight changes during clinical trials. Your health care provider may be able to provide more information. Please see the following Everyday Health link for more information on Nexium (esomeprazole). http://www.everydayhealth.com/drugs/nexium Laura Cable, PharmD

Q: Is Nexium safe to take during pregnancy?

A: Nexium (esomeprazole) is listed by the FDA as FDA pregnancy category B. Category B means that animal studies show no risk or adverse fetal effects, but controlled human first trimester studies are not available. This medication is not expected to be harmful to an unborn baby. Tell your doctor if you are pregnant or plan to become pregnant during treatment. It is not known whether Nexium passes into breast milk or if it could harm a nursing baby. Do not use this medication without telling your doctor if you are breastfeeding a baby.

Q: I have GERD and have been on Nexium for five years with fair success. I'm 67 years old. Recently, it seems like the 40 mg capsule is too strong, and I awaken every morning with a "sour" stomach and often diarrhea. I have tried dividing the dose 1/2 cap. in the morning and the other before dinner and this seems to work okay for a while. My doctor says I should be taking a full Nexium BID, but this often makes things worse. How do I know if my current symptoms are from taking too much or too little of the medication? Does one need less or more of the medication as one ages?

A: You should not divide the Nexium (esomeprazole) capsules because there is no way of measuring how much of the dose you are getting, and even though you divide it carefully, it may not mean that you have 20 mg in that one half capsule. It may be possible that long-term treatment with Nexium may cause tolerance to the medication, making it not as effective as it was initially. Tolerance is not generally associated with this medication, but that doesn't necessarily mean that it cannot happen. You generally shouldn't need to increase or decrease the dose as you age. You should discuss the situation with your physician and see if switching medications is a possible way to combat the symptoms. Also, the physician should look for other conditions that may be causing the symptoms.
Lori Poulin, PharmD

Q: What generic alternatives are there to Nexium?

A: Gastroesophageal reflux disease (GERD) is very common. Heartburn and regurgitation are the two most common symptoms of GERD. More than 60 million Americans experience heartburn at least once a month and more than 15 million Americans experience heartburn symptoms every day.
Treatment options for GERD include lifestyle modifications, medications, surgery, or a combination of methods. Over-the-counter preparations provide only temporary symptom relief. They do not prevent recurrence of symptoms or allow an injured esophagus to heal. They should not be taken regularly as a substitute for prescription medicines -- they may be hiding a more serious condition.
Carafate (sucralfate) is an oral gastrointestinal medication primarily indicated for the treatment of active duodenal ulcers. Sucralfate is also used for the treatment of GERD and stress ulcers. Sucralfate is a sucrose sulfate-aluminum complex that binds to the hydrochloric acid in the stomach and acts like an acid buffer with cytoprotective properties.
Over-the-counter medications such as antacids and antirefluxants (e.g., alginic acid) are viable treatment options for milder forms of GERD, and may relieve symptoms in approximately 20 percent of patients. A combination of the two therapies may be more effective than antacids alone. Histamine H2-receptor antagonists (H2RAs) have been shown to decrease gastric acid, and can be used as premedication by patients who are able to predict symptom occurrence. H2RAs are thought to remain effective for longer than antacids, although their peak potencies are similar. Over-the-counter prescription-dose omeprazole (Prilosec) is available in the United States for the short-term (i.e., 14 days) treatment of heartburn. Proton pump inhibitors (PPIs) are the most effective medications used in the treatment of GERD, healing ulcers, and irritation of the esophagus.

Q: What is Nexium?

A: Gastroesophageal reflux disease (GERD) is very common. More than 60 million Americans
experience heartburn at least once a month and more than 15 million Americans experience heartburn symptoms every day. GERD is a more serious form of gastroesophageal reflux (GER), which is common. Persistent reflux that occurs more than twice a week is considered GERD, and it can eventually lead to more serious health problems. The main symptom of GERD in adults is frequent heartburn, also called acid indigestionâ€”burning-type pain in the lower part of the mid-chest, behind the breast bone, and in the mid-abdomen.
Nexium (esomeprazole) is a proton pump inhibitor (PPI) used in the treatment of dyspepsia, peptic ulcer disease (PUD), GERD, and Zollinger-Ellison syndrome. PPIs decrease the amount of acid produced in the stomach. PPIs are the most effective medications used to decrease stomach acid. In adults 18 and older, side effects with Nexium include headache, diarrhea, and abdominal pain. In children 1 to 17 years of age, side effects with Nexium include headache, diarrhea, abdominal pain, nausea, and sleepiness.
The recommended dose of Nexium is 20 milligrams once daily for patients with acid reflux disease. For patients with acid reflux disease and erosive esophagitis, the recommended dose of Nexium ranges between 20 to 40 mg once daily. Nexium should be taken at least 1 hour before meals and at the same time each day. Each capsule of Nexium should be swallowed whole and not chewed or crushed. Nexium is not recommended for children under the age of 1 year. For children and adolescents 1 to 17 years of age, Nexium may be prescribed for up to 8 weeks for short-term treatment of GERD.
Long-term and multiple daily dose PPI therapy may be associated with an increased risk for osteoporosis-related fractures of the hip, wrist or spine.

Q: What is the difference between Prevacid versus Nexium?

A: Gastroesophageal reflux disease (GERD) is a common chronic, relapsing condition that carries a risk of significant morbidity and potential mortality from resultant complications. More than 60 million adult Americans suffer from heartburn at least once a month and over 25 million experience heartburn daily. Patients with GERD generally report decreases in productivity, quality of life and overall well-being. Solid evidence from numerous randomized controlled trials has shown that PPIs are more effective than both histamne-2 receptor antagonists (e.g., cimetidine, famotidine, nizatidine, and ranitidine) and placebo in controlling symptoms from erosive reflux disease (83% compared to 60% and 27%, respectively) over a 4 to 8 week period.
Prevacid (lansoprazole) is a proton pump inhibitor (PPI) frequently used for the treatment of GERD, and stomach/duodenal ulcers. Most common side effects with Prevacid include diarrhea, abdominal pain, nausea and constipation.
The recommended dose of Prevacid ranges between 15 and 30 mg daily. The safety and effectiveness of Prevacid have been established in pediatric patients 1 to 17 years of age for short-term treatment of symptomatic GERD and erosive esophagitis. Controlled studies with Prevacid do not extend beyond 12 months.
Nexium (esomeprazole) is a proton pump inhibitor used in the treatment of dyspepsia, peptic ulcer disease (PUD), GERD, and Zollinger-Ellison syndrome. In adults 18 and older, side effects with Nexium include headache, diarrhea, and abdominal pain. In children 1 to 17 years of age, side effects with Nexium include headache, diarrhea, abdominal pain, nausea, and sleepiness.
The recommended dose of Nexium ranges between 20 to 40 milligrams daily. Nexium is not recommended for children under the age of 1 year. For children and adolescents 1 to 17 years of age, Nexium may be prescribed for up to 8 weeks for short-term treatment of GERD.
Long-term and multiple daily dose PPI therapy may be associated with an increased risk for osteoporosis-related fractures of the hip, wrist or spine.

Q: What is the difference between Aciphex versus Nexium?

A: GERD affects approximately 14 to 20 percent of the adult U.S. population. It is a chronic condition that develops when acid content from the stomach flows back into the esophagus, and is most commonly associated with heartburn.
Aciphex (rabeprazole) is a proton-pump inhibitor indicated for adolescent patients 12 years of age and above for short-term treatment of symptomatic gastroesophageal reflux disease (GERD). Aciphex tablets should be swallowed whole. In adolescents, the most common side effects with Aciphex include headache, diarrhea, nausea, vomiting, and abdominal pain. In adults, the most common side effects with Aciphex include pain, sore throat, gas, infection, and constipation.
The recommended dose of Aciphex is 20 milligrams daily. Aciphex has not been studied for treatment lasting longer than 12 months (1 year). The safety and effectiveness of Aciphex has not been established for children under the age of 12.
Nexium (esomeprazole) is a proton pump inhibitor used in the treatment of dyspepsia, peptic ulcer disease (PUD), GERD, and Zollinger-Ellison syndrome. In adults 18 and older, side effects with Nexium include headache, diarrhea, and abdominal pain. In children 1 to 17 years of age, side effects with Nexium include headache, diarrhea, abdominal pain, nausea, and sleepiness.
The recommended dose of Nexium ranges between 20 to 40 milligrams daily. Nexium is not recommended for children under the age of 1 year. For children and adolescents 1 to 17 years of age, Nexium may be prescribed for up to 8 weeks for short-term treatment of GERD.
Long-term and multiple daily dose proton pump inhibitor therapy may be associated with an increased risk for osteoporosis-related fractures of the hip, wrist, or spine.

Q: What is Nexium, and what are its side effects?

A: Nexium (esomeprazole), one of a group of drugs called proton pump inhibitors, decreases the amount of acid produced in the stomach. Nexium is used to treat symptoms of gastroesophageal reflux disease (GERD) and other conditions involving excessive stomach acid such as Zollinger-Ellison syndrome, and is also used to promote healing of erosive esophagitis (damage to your esophagus caused by stomach acid). Nexium may also be given to prevent gastric ulcer caused by infection with helicobacter pylori (H. pylori), or by the use of nonsteroidal anti-inflammatory drugs (NSAIDs). Nexium is not for immediate relief of heartburn symptoms. The most common side effects with Nexium are headache, dizziness, rash, diarrhea, nausea/vomiting, and altered taste sensation. Less frequent, sever side effects include pancreatitis and hepatitis. This is not a complete list of the side effects associated with Nexium. Gregory Latham, RPh

Q: Is there a generic for Nexium 40mg?

A: Nexium (esomeprazole) is in a drug class called proton pump inhibitors. Nexium is used to treat gastroesophageal reflux disease (GERD). Nexium is also used to prevent ulcers (sores in the lining of the stomach) in people who are taking nonsteroidal anti-inflammatory drugs (NSAIDs). In combination with certain other medications, Nexium is used to treat and prevent the recurrence of stomach ulcers caused by H. pylori, a type of bacteria. Nexium is also used to treat conditions (e.g., Zollinger-Ellison Syndrome) in which the stomach makes too much acid. Nexium works be reducing acid production in the stomach. Generic drugs are lower-cost alternatives to more expensive brand-name drugs. They will appear different and have a few other minor differences from the brand-name drugs, but their labeling and directions for use must be virtually the same as that of the brand name product. Both brand-name and generic drug manufacturing facilities must follow the same standards of good manufacturing practices and meet the U.S. Food and Drug Administration's (FDA) specifications. The FDA also requires that generic drugs be bioequivalent to their brand-name counterparts. This means that a generic drug will work the same way in your body as the brand-name medication. Generics are considered by the FDA to be identical to brand-name drugs in dose, strength, route of administration, safety, efficacy, and intended use. Currently there is not a generic version of Nexium available. The price of a medication, like Nexium, can vary depending on the wholesaler and pharmacy from which the medication is acquired. Pharmacies sell medication to consumers at a price that includes the cost for acquiring the drug from the wholesaler, plus a retail markup. If a third-party payer (for example, a health insurance company or Medicare) is providing coverage for a medication, such as Nexium, they determine the final cost of the product. Costs will vary from one plan to another, and the payer may cover or reimburse part or all of the cost. In addition to Nexium, Aciphex (rabeprazole), Kapidex (dexlansoprazole), Nexium (esomeprazole), Prevacid (lansoprazole), Prilosec (omeprazole), and Protonix (pantoprazole) belong to the proton pump inhibitor drug class. Studies show that, in general, proton pump inhibitors are about equally effective. Moreover, in general, there is little scientific evidence that there are any important differences in the safety of the proton pump inhibitors. As such, many third-party payers promote

Q: Can Nexium cause aches and pains after long term use?

A: Nexium (esomeprazole) belongs to a class of medications called Proton-Pump Inhibitors. Nexium decreases the amount of acid that is in the stomach and relieves heartburn that is caused by backflow of the stomach acid from the stomach to the esophagus. Nexium is indicated for the treatment of GERD or gastroesophageal reflux disease. Nexium is also used for a condition called Zollinger-Ellison syndrome. Nexium can be used to heal damage done to the esophagus from stomach acid and prevent gastric ulcers that are caused by certain bacteria. Nexium may be prescribed with certain antibiotics to treat bacteria called H Pylori. Ulcers may also develop from the use of Nonsteroidal anti-inflammatory drugs (NSAIDs) such as Advil, Motrin (ibuprofen) and Aleve (naproxen). Nexium should be taken exactly as prescribed by the doctor. Nexium is a delayed release capsule or it should never be crushed or chewed to provide maximum benefit. Nexium can be opened and put with applesauce if the capsules cannot be swallowed. Nexium is usually taken at least one hour before food generally in the morning with a full glass of water. Unfortunately, Nexium will not provide immediate relief of heartburn symptoms. Nexium may take a few days to provide relief from symptoms of GERD. Common side effects associated with Nexium include dizziness, headache, diarrhea, constipation and dry mouth. Other less common side effects occurring in less than 1% of patients treated with Nexium include muscle pain, rash, back pain, chest pain, malaise or feeling "out of sorts" and flu-like symptoms. This is not a complete list of the side effects associated with Nexium. Kimberly Hotz, PharmD

Q: How long can you take Nexium without serious complications? Can it cause throat polyps?

A: Nexium (esomeprazole) is in a drug class called proton pump inhibitors. Nexium is used to treat gastroesophageal reflux disease (GERD). Nexium is also used to prevent ulcers (sores in the lining of the stomach) in people who are taking nonsteroidal anti-inflammatory drugs (NSAIDs). In combination with certain other medications, Nexium is used to treat and prevent the recurrence of stomach ulcers caused by H. pylori, a type of bacteria. Nexium is also used to treat conditions (e.g., Zollinger-Ellison Syndrome) in which the stomach makes too much acid. Nexium works be reducing acid production in the stomach. The safety of Nexium has been assessed in over 15,000 people in clinical trials around the world, according to its prescribing information. Over 2900 people were treated with Nexium in long-term studies -- up to 6 to 12 months. Generally, Nexium was well tolerated in short-term and long-term clinical trials. The most common side effects with Nexium are: headache, diarrhea, nausea, excessive gas, abdominal pain, constipation, and dry mouth. Atrophic gastritis has been reported in people treated long-term with omeprazole. Structurally, omperazole is a mirror image of Nexium. Atrophic gastritis is a condition where the normal glands of the stomach are decreased or absent; inflammation is present; and stomach cells are damaged. Atrophic gastritis is a precursor for stomach cancer. The cancer-causing potential of Nexium was assessed using studies with omeprazole in rats. Two 24-month studies looked at rats given doses of omeprazole 0.7 to 57 times a normal human dose. In these studies, rats that got omeprazole were more likely to get stomach tumors. Benign (non-cancerous) polyps or nodules of the gastrointestinal tract have been observed in people following treatment with Nexium. Nexium has been shown to be safe and effective over long periods of time to treat conditions in which the stomach makes too much acid (e.g., Zollinger-Ellison Syndrome). Long-term use of proton pump inhibitors has not been proven to cause stomach cancer in humans. New safety information has become available regarding the use of proton pump inhibitors. The safety information includes a possible increased risk of fractures of the hip, wrist and spine with the use of the medications. Studies have found that the greatest risk of fractures were in people who received high doses of proton pump inhibitors or in people who used the medications for 1 year or more. In general, the risks of taking a medication must be weighed against its health benefits. Derek Dore, PharmD

Q: Are there risks with long-term use of Nexium?

A: Nexium (esomeprazole) belongs to a class of drugs called proton pump inhibitors. PPIs decrease the amount of acid produced by the stomach. They are used to treat the symptoms of gastro-esophageal reflux disease (GERD), to heal erosive esophagitis, and to treat or prevent ulcers. PPIs have been around for over 20 years and have good safety record, even with long-term use. However, there are some precautions to consider. The major long-term side effects of PPIs is a vitamin B12 deficiency, and more rarely an iron deficiency. In addition to blocking the acid pumps in the stomach, PPIs also block the production of a protein in the stomach called intrinsic factor. Intrinsic factor is necessary for the proper absorption of vitamin B12. So, over many years, a deficiency may develop. This can be treated with vitamin B12 supplements, if advised by your doctor. Another risk with long-term use is a possible increased risk of fractures of the hip, wrist, and spine. Studies are not clear at this point about whether PPIs actually cause the increased risk or if it is due to some other factor. For now, tell your doctor if you develop any new bone pain. Your doctor is best able to guide your treatment decisions. Sarah Lewis, PharmD

Q: Does Nexium cause bone loss?

A: Nexium (esomeprazole) is a medication that is used to treat various conditions of the esophagus and stomach. It is classified in the class of medications called proton pump inhibitors (PPIs). Nexium works by disabling acid producing pumps in the stomach which lessens the amount of acid available to cause your symptoms. According to the prescribing information for Nexium, a precaution concerning the bones indicates, based on studies, that patients taking proton pump inhibitors may be at an increased risk for bone fracture. The increased risk appears to be highest for patients who take high doses of the medications for over one year. Consult with your physician to determine if the benefits of Nexium outweigh the risks for your particular situation. For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. Lori Poulin, PharmD

Q: Will taking Nexium for years harm my stomach and maybe even cause stomach cancer?

A: Nexium (esomeprazole) belongs to a class of medication known as proton pump inhibitors. Nexium is used to treat symptoms of gastroesophageal reflux disease (GERD) and gastric ulcers. Current evidence does not support Nexium causing stomach cancer with long term use. Megan Uehara, PharmD

Q: I take Nexium every day in the morning. How will that interfere with absorption of any vitamins or supplements I take? Also, which calcium supplement is best for me? I now take Tums before bed and take a vitamin D tablet.

A: Nexium (esomeprazole) is a proton pump inhibitor (PPI) which is used for the treatment of gastroesophageal reflux disease (GERD), hypersecretory conditions, such as Zollinger-Ellison syndrome, and for combination treatment of Helicobacter pylori (H. pylori) infection. Proton pump inhibitors decrease the amount of gastric acid that is released into the gastrointestinal system. This decrease in stomach acid can decrease the absorption of some vitamins and minerals. Calcium absorption can be decreased in patients taking acid lowering medications, such as Nexium. Tums are calcium carbonate which may have decreased absorption when administered concomitantly with Nexium. Calcium citrate (Citracal) is less likely to be affected by gastric acid levels, so it can be a better choice of calcium supplement for patients taking Nexium. Vitamin D also helps with calcium absorption. It is recommended to get 800 to 1000 IU of vitamin D daily. Patients who are on long-term treatment with proton pump inhibitors, such as Nexium, may have decreased absorption of vitamin B12 and supplementation with vitamin B12 may be necessary to avoid deficiency. Proton pump inhibitors, such as Nexium, may cause decreased absorption of iron. Your doctor can perform blood tests to ensure you are getting enough iron and vitamin B12 from your diet or supplements. Nexium should be taken on an empty stomach about one hour before breakfast or the first meal of the day. Swallow the Nexium capsule whole do not chew or crush. For those who have difficulty swallowing capsules, the capsule contents may be sprinkled on applesauce and swallowed immediately. Some of the most common side effects associated with Nexium are headache, gas, abdominal pain, upset stomach, nausea and dizziness. For more specific information, consult with your doctor or pharmacist for guidance based on your health status and current medications, particularly before taking any action. Laura Cable, PharmD

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